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Angiopoietin Balance in Septic Shock Patients With Acute Lung Injury: Effect of Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber
Author(s) -
Ebihara Itaru,
Hirayama Kouichi,
Nagai Miho,
Kakita Tomoko,
Sakai Kentaro,
Tajima Reiko,
Sato Chihiro,
Kurosawa Hiromi,
Togashi Amane,
Okada Akiko,
Usui Joichi,
Yamagata Kunihiro,
Kobayashi Masaki
Publication year - 2011
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2011.00963.x
Subject(s) - hemoperfusion , medicine , septic shock , angiopoietin , sepsis , polymyxin b , pathogenesis , angiopoietin 2 , gastroenterology , anesthesia , antibiotics , microbiology and biotechnology , vascular endothelial growth factor , hemodialysis , vegf receptors , biology
Acute lung injury (ALI) in sepsis is characterized by an increase in microvascular permeability, resulting in pulmonary edema. Several studies have suggested that angiopoietin‐1 and ‐2 play a contributory role in the pathogenesis of ALI. Polymyxin B‐immobilized fiber column hemoperfusion is effective for sepsis‐induced ALI. We investigated the angiopoietin levels before and after direct hemoperfusion with polymyxin B‐immobilized fiber column (PMX) therapy. Enzyme‐linked immunoassay was used to measure the serum angiopoietin‐1 and ‐2 levels in 25 patients with septic shock treated with PMX. Eleven of the 25 patients were diagnosed with ALI. There was a significant positive correlation between the angiopoietin‐1 level and the PaO 2 /FiO 2 ratio, but there was a significant inverse correlation between the angiopoietin‐2 level and the PaO 2 /FiO 2 ratio. The mean angiopoietin‐1 level before PMX therapy in the ALI group was significantly lower and the mean angiopoietin‐2 level was significantly higher than in the non‐ALI group. The mean angiopoietin‐1 level of the ALI patients in response to PMX therapy was increased during PMX therapy, but that of the non‐ALI patients with newly occurring ALI showed a decreased angiopoietin‐1 level. On the other hand, the mean angiopoietin‐2 level of the responders was decreased during PMX therapy, but that of patients with newly occurring ALI showed an increased angiopoietin‐2 level. This result suggested that each angiopoietin‐1 and ‐2 level may play a role in the pathogenesis of ALI and that PMX therapy ameliorates the angiopoietin balance in patients with ALI in sepsis.